What is Oropharyngeal Dysphagia & How is it Treated?

The difficulty that is faced while transferring food from the mouth to the pharynx and the esophagus which is the involuntary swallowing process is known as oropharyngeal dysphagia or transfer dysphagia. The patient is known to have been suffering from oropharyngeal dysphagia or transfer dysphagia when he or she feels a sensation (subjective in nature) or develops an abnormality while swallowing.

The initiation of the difficulty that occurs with oropharyngeal dysphagia or transfer dysphagia is finding it difficult to swallow food. Other than swallowing, the other hindrances that can accompany swallowing are aspiration, nasopharyngeal regurgitation and residue of food remaining back in the pharynx.

There are several factors due to which the muscles of your throat can get weak and you will find difficulty in swallowing or have uneasy sensation in the esophagus when the food reaches it. The other distressed feelings that you may face are choking, gagging and coughing while you try to swallow your food. It may further send back the fluid in your food from the pharynx to the windpipe and then release it through your nose which may lead to pneumonia.

There are many causes for oropharyngeal dysphagia or transfer dysphagia:

• Certain disorders which are neurological in nature. For example, you may develop oropharyngeal dysphagia or transfer dysphagia, if you have suffered or are suffering from multiple sclerosis, parkinson’s disease and muscular dystrophy.
• Any kind of neurological damage that has occurred from a stroke, brain damage, an injury in the spinal cord can make swallowing difficult.
• Sometimes a small pouch like layer is formed in the throat just above the esophagus. It is called pharyngeal diverticula. This pouch often stores some particles of food and results in bad breath, difficulty in swallowing, coughing, gurgling sound and repetitive throat clearing.
• Certain kinds of cancer and its treatment like using ray therapy may cause oropharyngeal dysphagia or transfer dysphagia or difficulty in swallowing.

Below are some of the signs and symptoms of oropharyngeal dysphagia or transfer dysphagia:

• Developing a pain while trying to swallow food which is also known as odynophagia is a symptom of oropharyngeal dysphagia or transfer dysphagia.
• Not being able to swallow food at all and therefore you might have to cut the food into smaller pieces and avoid certain kinds of food entirely to make your eating process easier.
• Developing a sensation that the food is stuck in your throat, behind your breastbone or your chest.
• Dizziness.
• Developing a hoarse voice and having to clear throat constantly while speaking.
• The food and the acid coming back to your mouth or coming out through your nose which is known as regurgitation is also a sign of oropharyngeal dysphagia or transfer dysphagia.
• Developing frequent sensations of heart burns.
• Losing weight randomly and unexpectedly.
• Bad breath.

If you develop regularity in the difficulty of swallowing food and other symptoms like loss of weight, vomiting, regurgitation then you should consult a doctor immediately. You must call for an emergency medical help if you feel that you are unable to breathe due to choking or the food is struck in your throat or chest.

Your doctor will likely perform a physical examination and may use a variety of tests to determine the cause of your swallowing problem. Various physical and clinical tests are performed by the doctors to conform if you are suffering from oropharyngeal dysphagia or transfer dysphagia:

• X-ray test with a contrast material like barium is used to diagnose oropharyngeal dysphagia or transfer dysphagia. The doctor asks you to swallow liquid barium which coats your esophagus and helps to get a clear image during the X-ray. Sometimes you may have to take in solid barium tablets to find out the blockages in your esophagus which the liquid barium could not identify. In this way, the shape of your esophagus and its muscular activity can be studied.
• Dynamic swallowing study may be conducted for diagnosing oropharyngeal dysphagia or transfer dysphagia. Different amount of barium is coated on different food and you swallow these foods. In this way the muscular activity and the mismanagement between your mouth and throat can be captured from the images and it will also show if any amount of food is entering the wind pipe.
• Endoscopy. Examining your esophagus visually by passing through a fine tube like flexible instrument called the endoscope through your esophagus to see the esophagus from inside.
• Another test to diagnose oropharyngeal dysphagia or transfer dysphagia is manometry or muscle test of the esophagus. Along with the endoscope that in passed through the esophagus, a small pressure recorder is attached that helps to study the muscular movement of the esophagus while swallowing.
• FEES (fibre-optic endoscopic swallowing evaluation). As you try your swallowing activity, a camera is attached to the endoscope with a lighted tube to collect imagery of the esophagus in movement.
• Imagine scans is a combination of CT scan, MRI scan, and X-ray imaging gets the cross-sectional images of the bones, soft tissues and organs. PET scan or positron emission tomography which uses a radioactive drug tracer can be sued to study the function of the esophagus.

When you visit a doctor for treating the oropharyngeal dysphagia or transfer dysphagia, the doctor may suggest you to:

Carry out certain exercises which will ease the throat muscles and re stimulate the nerves which help to carry out the swallowing process. Doctor will suggest you several swallowing techniques like ways of placing food in your mouth and turning your head and body accordingly to swallow.

The common risk factors of oropharyngeal dysphagia or transfer dysphagia are:

• Aging: with the growing age, the esophagus of every human undergoes wear and tear and therefore becomes weak. Oropharyngeal dysphagia or transfer dysphagia is prone to be developed if the patient has undergone a stroke due to old age or suffers from the late stage of Parkinson’s disease.
• Difficult Heath Conditions: If the person has undergone any neurological surgery or suffers from any disorder in the nervous system, he or she may develop the trait of finding difficulty in swallowing.

Oropharyngeal dysphagia or transfer dysphagia may lead to:

• Oropharyngeal dysphagia or transfer dysphagia leads to difficulty in taking in food in adequate amount which may cause Weight loss, malnutrition and dehydration.
• When the food you are trying to swallow enters your windpipe it may give rise to respiratory troubles, respiratory infections and may even cause pneumonia.

When you are suffering from oropharyngeal dysphagia or transfer dysphagia, along with seeing a doctor, some of the things that you may try doing at home to ease your swallowing process are:

• Developing a new eating habit which will include eating at regular and frequent intervals but small amount of food is a good lifestyle change for oropharyngeal dysphagia or transfer dysphagia. Also cut your food into smaller pieces and eat slowly.
• Finding out what kind of food is troubling your swallowing process and avoiding them. While some people find difficulty is swallowing liquids like coffee others find difficulty in eating sticky food like nuts and butter.
• Avoiding objects like alcohol, tobacco and caffeine which give rise to frequent heart burns.

Even though the difficulty in swallowing can be treated and avoided, you must develop a habit of eating slowly and chewing the food finely before swallowing. GERD can also be avoided if it is detected at its early stage. This shall further prevent any risk of developing oropharyngeal dysphagia or transfer dysphagia which disrupts the esophageal structure.